{"title":"心肺旁路过程中大腿区域组织氧饱和度监测对心脏手术后肺损伤的预测作用","authors":"Tomoki Tamura, Fumiaki Shikata, Tadashi Kitamura, Masaomi Fukuzumi, Yuki Tanaka, Tomoyo Ebine, Kiyotaka Fujii, Satoshi Kohira, Kagami Miyaji","doi":"10.1007/s10047-024-01438-y","DOIUrl":null,"url":null,"abstract":"<p>Acute respiratory distress syndrome (ARDS) is a serious complication following cardiac surgery mainly associated with the use of cardiopulmonary bypass (CPB), which could increase the risk of mortality and morbidity. This study investigated the association of regional oxygen saturation (rSO<sub>2</sub>) during CPB with postoperative outcomes, including respiratory function. Patients who underwent cardiac surgery with CPB from 2015 to 2019 were included. Near-infrared spectroscopy was used to monitor rSO<sub>2</sub> at the forehead, abdomen, and thighs throughout the surgery. Postoperative markers associated with CPB were assessed for correlations with PaO<sub>2</sub>/FiO<sub>2</sub> (P/F) ratios at intensive care unit (ICU) admission. Postoperative lung injury (LI) was defined as moderate or severe ARDS based on the Berlin criteria, and its incidence was 29.9% (20/67). On multiple regression analysis, the following were associated with P/F ratios at ICU admission: vasoactive-inotropic scores at CPB induction (<i>P</i> = 0.03), thigh rSO<sub>2</sub> values during CPB (<i>P</i> = 0.04), and body surface area (<i>P</i> < 0.001). A thigh rSO<sub>2</sub> of 71% during CPB was significantly predictive of postoperative LI with an area under the curve of 0.71 (<i>P</i> = 0.03), sensitivity of 0.70, and specificity of 0.68. Patients with postoperative LI had longer ventilation time and ICU stays. Thigh rSO<sub>2</sub> values during CPB were a potential predictor of postoperative pulmonary outcomes.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"48 1","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive role of regional thigh tissue oxygen saturation monitoring during cardiopulmonary bypass in lung injury after cardiac surgery\",\"authors\":\"Tomoki Tamura, Fumiaki Shikata, Tadashi Kitamura, Masaomi Fukuzumi, Yuki Tanaka, Tomoyo Ebine, Kiyotaka Fujii, Satoshi Kohira, Kagami Miyaji\",\"doi\":\"10.1007/s10047-024-01438-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Acute respiratory distress syndrome (ARDS) is a serious complication following cardiac surgery mainly associated with the use of cardiopulmonary bypass (CPB), which could increase the risk of mortality and morbidity. This study investigated the association of regional oxygen saturation (rSO<sub>2</sub>) during CPB with postoperative outcomes, including respiratory function. Patients who underwent cardiac surgery with CPB from 2015 to 2019 were included. Near-infrared spectroscopy was used to monitor rSO<sub>2</sub> at the forehead, abdomen, and thighs throughout the surgery. Postoperative markers associated with CPB were assessed for correlations with PaO<sub>2</sub>/FiO<sub>2</sub> (P/F) ratios at intensive care unit (ICU) admission. Postoperative lung injury (LI) was defined as moderate or severe ARDS based on the Berlin criteria, and its incidence was 29.9% (20/67). On multiple regression analysis, the following were associated with P/F ratios at ICU admission: vasoactive-inotropic scores at CPB induction (<i>P</i> = 0.03), thigh rSO<sub>2</sub> values during CPB (<i>P</i> = 0.04), and body surface area (<i>P</i> < 0.001). A thigh rSO<sub>2</sub> of 71% during CPB was significantly predictive of postoperative LI with an area under the curve of 0.71 (<i>P</i> = 0.03), sensitivity of 0.70, and specificity of 0.68. Patients with postoperative LI had longer ventilation time and ICU stays. Thigh rSO<sub>2</sub> values during CPB were a potential predictor of postoperative pulmonary outcomes.</p>\",\"PeriodicalId\":15177,\"journal\":{\"name\":\"Journal of Artificial Organs\",\"volume\":\"48 1\",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-03-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Artificial Organs\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1007/s10047-024-01438-y\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Artificial Organs","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s10047-024-01438-y","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
Predictive role of regional thigh tissue oxygen saturation monitoring during cardiopulmonary bypass in lung injury after cardiac surgery
Acute respiratory distress syndrome (ARDS) is a serious complication following cardiac surgery mainly associated with the use of cardiopulmonary bypass (CPB), which could increase the risk of mortality and morbidity. This study investigated the association of regional oxygen saturation (rSO2) during CPB with postoperative outcomes, including respiratory function. Patients who underwent cardiac surgery with CPB from 2015 to 2019 were included. Near-infrared spectroscopy was used to monitor rSO2 at the forehead, abdomen, and thighs throughout the surgery. Postoperative markers associated with CPB were assessed for correlations with PaO2/FiO2 (P/F) ratios at intensive care unit (ICU) admission. Postoperative lung injury (LI) was defined as moderate or severe ARDS based on the Berlin criteria, and its incidence was 29.9% (20/67). On multiple regression analysis, the following were associated with P/F ratios at ICU admission: vasoactive-inotropic scores at CPB induction (P = 0.03), thigh rSO2 values during CPB (P = 0.04), and body surface area (P < 0.001). A thigh rSO2 of 71% during CPB was significantly predictive of postoperative LI with an area under the curve of 0.71 (P = 0.03), sensitivity of 0.70, and specificity of 0.68. Patients with postoperative LI had longer ventilation time and ICU stays. Thigh rSO2 values during CPB were a potential predictor of postoperative pulmonary outcomes.
期刊介绍:
The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.